Pharmacology for Depressive Disorders

Question 1

SSRIs
Mechanism of Action

Answer 1

selectively block reuptake of the monoamine neurotransmitter serotonin in the synaptic space, which intensifies the effects of serotonin

These are 1st line of treatment for depression

Question 2

SSRIs
Indication/Contraindication

Answer 2

Indicated for depression, OCD, bulimia, PMDD, panic disorders, PTSD, social anxiety disorder, GAD, bipolar

Contraindicated in pregnancy, MAOI usage, TCA usage

exercise caution in patients with liver or kidney dysfunction, cardiac disease, seizure disorders, diabetes, or GI ulcer hx

Question 3

SSRIs
Side effects

Answer 3

sexual dysfunction, CNS stimulation (insomnia), weightloss then gain, serotonin syndrome !!, withdrawals (headache, nausea, anxiety, dizziness, rash, sleepy, GI bleeding

Question 4

SSRIs

Answer 4

Fluoxetine
Sertraline
Paroxetine
Citalopram
Escitalopram
Fluvoxamine

Question 5

SSRIs
Nursing Considerations

Answer 5

-these take 1-3 weeks or longer to effect the body
-educate patient on symptoms of serotonin syndrome (disorientation, tachycardia, diaphoresis, tremors, etc.) this is an emergency
- do NOT abrptly stop the med, educate patient to slowly taper off
-Paroxetine can cause birth defects, always ensure patient on this drug is not trying to get pregnant
- use of MAOIs, TCAs, and St Johns wort increase the risk for serotonin syndrome

Question 6

SSNRIs
Mechanism

Answer 6

block reuptake of norepinephrine as well as serotonin

Question 7

SSNRIs
Indications/Contraind.

Answer 7

Indicated for major depression, GAD, Panic disorder, some pain disorders

Contraindicated in pregnancy, breastfeeding, MAOI use, TCA use

Question 8

SSNRIs
Side effects

Answer 8

nausea, anorexia, weight loss, headache, insomnia, anxiety, hypertension, tachycardia, dizziness, blurred vision, risk for suicide in adolescents, serotonin syndrome, sexual dysfunction

Question 9

SSNRIs

Answer 9

Venlafaxine
Desvenlafaxine
Duloxetine
Levomilnacipran

Question 10

SSNRIs
Nursing Considerations

Answer 10

• educate patients on signs of Serotonin syndrome
• if patient is an adolescent assess them for suicidal ideation and make parents aware
• taper dose gradually to avoid withdrawal symptoms
• don’t take along with MAOIs, TCAs, St. John’s Wort